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Abdominal landmarks
xiphoid process
lower margin of costal
arch
iliac antero-superior
spina
Abdominal regions
four quadrants system
nine regions system
Regions
right & left
hypochondrial
right & left lumber
right & left iliac
epigastric
Right hypochondrial
liver gallbladder
right kidney
hepatic flexure of colon
right lumber
ascending colon jejunum
Epigastric
liver (left lobe) pylorus
duodenum omentum
transverse colon
the head and body of pancreas
umbilical
Left hypochondrial
spleen stomach
splenic flexure of colon
pancreas (tail part )
left kidney
left lumber
Inspection
1. Abdominal contour
in healthy person abdomen is
usually flat from xiphoid to
symphysis pubis , we call
abdominal flat or even abdomen.
the umbilicus is located in the
Abdominal bulge
generalized abdominal bulge is
usually caused by ascites
some causes for ascites:
heart failure
cirrhosis of liver
Abdominal retraction
anterior abdominal wall is much lower
than the level from xiphoid to
symphysis pubis,
2. Respiratory movement
the manner of breathing: in men
and children, manner of breathing
is abdominal respiration. But in
women the manner of breathing is
thoracic respiration. In some
3. Abdominal veins
in healthy person abdominal
vein can not be seen or or can
be seen a little in thin person,
but not dilated, in patient with
obstruction of the portal
(2) Pigment
in normal condition, the pigment
of abdomen is more decreased
than exposed part of skin, in
patient with chronic
adrenocortical hypofunction also
(3) Striae
silver striae distribute on the
lower quadrants of abdomen or
iliac regions, it is seen after a large
gain of weight or after pregnancy.
bluish striae (purple) distribute
(4) Scar
when you find a operation scar
on the patient abdomen, you
should ask some question about
the scar, when and why the
patient got the scar, the history
(5). Hernia
umbilical hernia may be seen in
belly or patient with a massive
ascites
incisional hernia operation scar
femoral hernia mainly seen in